Peritoneovenous shunt scintigraphy to assess shunt patency in patients with refractory ascites.

Peritoneovenous shunt scintigraphy is an infrequently performed study to non-invasively assess shunt patency in patients with recurrent or refractory ascites in cirrhotic patients. We describe two patients of chronic liver disease in whom (99m)Tc-macroaggregated albumin scintigraphy was performed to assess the patency of peritoneovenous shunt. Visualization of lung activity was interpreted as indicative of shunt patency. While both lungs were visualized almost immediately in the first patient, they were visualized by 30 min in the second patient. Visualization of radiolabeled peritoneal fluid in the entire length of the shunt tubing may be variable, and was seen in only one patient. Scintigraphy also helped in excluding communication between the ascites and right groin collection in the second patient.